Radiological findings in bile duct carcinoma

Radiological findings in 58 cases of pathologically proven bile duct carcinoma were analysed retrospectively. 11 patients had peripheral intrahepatic cholangiocarcinoma, 30 either hepatic duct or choledochal carcinoma and 17 carcinoma of the papilla of Vater. The tumour was local abdominally in 41 and spread abdominally in 17 cases. All cases but one were examined by US, 27 by CT, 19 by PTC, 28 by ERCP and 11 by angiography. US showed bile duct obstruction in all the cases in which it was present and CT in 94%. US showed the primary tumour in 63% and CT in 44%, while the figures for showing abdominal spread were 56 and 17% respectively. No tumour mass was found at US in 28% of cases or at CT in 52%. ERCP failed in 3 out of 28 cases, showed a tumour in 24 (86%) and showed ambiguous narrowing of the bile duct in one. PTC showed obstruction or narrowing of the bile duct caused by a tumour in all cases, while angiography detected all the intrahepatic cholangiocarcinomas but was abnormal in only 2 out of 6 cases of extrahepatic bile duct carcinoma.